title: Vaginal cuff dehiscence after hysterectomy.
abstract: OBJECTIVE
  To determine the incidence of vaginal cuff dehiscence (VCD) among women undergoing hysterectomy according to clinico-surgical factors including surgical route, and to describe patient characteristics associated with VCD.
  
  
  METHODS
  In a retrospective study, the medical records of all women who underwent hysterectomy between January 2005 and March 2011 at a university teaching hospital in Seoul, Republic of Korea, were reviewed. The incidence of VCD was determined in relation to the following factors: patient age, hysterectomy route, indication for hysterectomy, and extent of resection (either simple or radical hysterectomy).
  
  
  RESULTS
  Among 9973 hysterectomies, 37 (0.37%) cases of VCD were identified. The incidence of VCD was significantly higher after abdominal hysterectomy (0.6%) than after laparoscopic (0.2%) or vaginal (0.4%) hysterectomy (P=0.016). Compared with laparoscopic approaches, abdominal hysterectomy was associated with a higher risk of VCD (odds ratio, 2.735; 95% confidence interval, 1.380-5.420). However, there was no significant difference in the incidence of VCD according to surgical indication or extent of resection.
  
  
  CONCLUSIONS
  Laparoscopic hysterectomy was found to be associated with a lower risk of VCD compared with abdominal hysterectomy. The lower risk is probably related to the different techniques used for colpotomy and cuff closure.
authors.affiliation: Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Yu-Jin
authors.initials: YJ
authors.lastname: Koo
authors.forename: Dae-Yeon
authors.initials: DY
authors.lastname: Kim
authors.forename: Jong-Hyeok
authors.initials: JH
authors.lastname: Kim
authors.forename: Yong-Man
authors.initials: YM
authors.lastname: Kim
authors.forename: Young-Tak
authors.initials: YT
authors.lastname: Kim
authors.forename: Joo-Hyun
authors.initials: JH
authors.lastname: Nam
mesh_terms: D000328:Adult; D000367:Age Factors; D020884:Colpotomy / Q000379:methods; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods; D007045:Hysterectomy, Vaginal / Q000009:adverse effects / Q000379:methods; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008875:Middle Aged; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D013529:Surgical Wound Dehiscence / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D014623:Vaginal Diseases / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology
keywords: Complication; Hysterectomy; Laparoscopy; Vault dehiscence